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Circulating levels of fibroblast growth factor 21 in early-stage diabetic kidney disease

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Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Aims/purpose

Fibroblast growth factor 21 (FGF21), a hepatoadipokine with pleiotropic metabolic regulatory actions, is emerging as a novel biomarker of progressive nephropathy. We sought to evaluate circulating FGF21 and its association with clinical and biochemical characteristics as well as the urinary albumin excretion (UAE) rates in a population of patients with type 2 diabetes (T2D) with or without microalbuminuria and their matched healthy controls.

Methods

Cross-sectionally, 130 consecutive individuals comprising patients with T2D with (n = 44) or without (n = 44) microalbuminuria and their healthy controls (n = 42) were recruited for analysis. Various demographic, clinical and biochemical parameters were assessed.

Results

Serum FGF21 levels were significantly elevated in patients with microalbuminuria [median (interquartile range, IQR): 269.50 (188.50) pg/mL] compared to their normoalbuminuric peers with T2D [median (IQR): 103.50 (75.75) pg/mL] and nondiabetic people [median (IQR): 99.00 (126.75) pg/mL]. While serum FGF21, diastolic blood pressure and duration of diabetes mellitus (DDM) were independently associated with microalbuminuria in the baseline logistic regression model, FGF21 and DDM emerged as significant correlates in the multivariate adjusted model (OR for FGF21 = 1.060, 95% CI = 1.011–1.110, P < .016).

Conclusions

Serum FGF21 level is strongly associated with early-stage diabetic kidney disease in the high-risk population of patients with T2D (particularly with circulating FGF21 values rising above 181 pg/mL). The association of serum FGF21 with subclinical stages of diabetic nephropathy may unearth perspectives on early detection and prevention of the advanced stages of chronic diabetes microvascular complications through effective FGF21-targeted therapy.

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Authors and Affiliations

  1. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran

    A. Esteghamati, A. Khandan, A. Momeni, A. Behdadnia, A. Ghajar, M. S. Nikdad, S. Noshad, M. Nakhjavani & M. Afarideh

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  1. A. Esteghamati
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  2. A. Khandan
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  3. A. Momeni
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  4. A. Behdadnia
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  5. A. Ghajar
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  6. M. S. Nikdad
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  7. S. Noshad
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  8. M. Nakhjavani
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Correspondence to A. Esteghamati.

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Funding

This study has received no funding/grant in any form and the authors are solely responsible for the credibility of the reported findings.

Conflict of interest

Alireza Esteghamati declares that he has no conflict of interest. Amirhossein Khandan declares that he has no conflict of interest. Alireza Momeni declares that he has no conflict of interest. Aram Behdadnia declares that she has no conflict of interest. Alireza Ghajar declares that he has no conflict of interest. Mohammad Sadegh Nikdad declares that he has no conflict of interest. Sina Noshad declares that he has no conflict of interest. Manouchehr Nakhjavani declares that he has no conflict of interest. Mohsen Afarideh declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Esteghamati, A., Khandan, A., Momeni, A. et al. Circulating levels of fibroblast growth factor 21 in early-stage diabetic kidney disease. Ir J Med Sci 186, 785–794 (2017). https://doi.org/10.1007/s11845-017-1554-7

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  • DOI: https://doi.org/10.1007/s11845-017-1554-7

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